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Sirolimus-eluting Stent compared with Paclitaxel-eluting Stent for Coronary Revascularization

ISAR-DIABETES Trial. Sirolimus-eluting Stent compared with Paclitaxel-eluting Stent for Coronary Revascularization. Presented at American College of Cardiology Scientific Sessions 2005 Presented by Dr. Adnan Kastrati. SIRTAX Trial.

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Sirolimus-eluting Stent compared with Paclitaxel-eluting Stent for Coronary Revascularization

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  1. ISAR-DIABETES Trial Sirolimus-eluting Stent compared with Paclitaxel-eluting Stent for Coronary Revascularization Presented at American College of Cardiology Scientific Sessions 2005 Presented by Dr. Adnan Kastrati

  2. SIRTAX Trial 250 diabetic patients with symptomatic coronary artery disease, presence of at least one lesion covered with one or multiple stents of ≥50% stenosis, and anatomy suitable for coronary stenting Randomized, single center Paclitaxel-eluting Stent n=125 Sirolimus-eluting Stent n=125 Endpoints: Primary- Late Loss (6 months) Secondary- Angiographic restenosis (6 months) and TLR (9 Months) Presented at ACC Scientific Sessions 2005

  3. ISAR-DIABETES Trial Late Lumen Loss Angiographic Re-stenosis p=0.03 In-lesion P<0.001 In-stent p<0.002 mm Sirolimus Sirolimus Paclitaxel Paclitaxel Sirolimus Paclitaxel • Late lumen loss was lower in the sirolimus-eluting stent group compared with the paclitaxel-eluting stent group both in-stent and in-lesion. • Likewise, angiographic re-stenosis was also lower in the sirolimus-eluting stent group Presented at ACC Scientific Sessions 2005

  4. ISAR-DIABETES Trial Primary Endpoint (Late Loss) Hazard Ratio [HR] 0.24 95% CI 0.09-0.39 p=0.002 • The primary endpoint of late loss at 6 months was lower in the sirolimus-eluting stent group vs the paclitaxel-eluting stent. • The secondary endpoint of angiographic restenosis was also lower in the sirolimus-eluting stent group vs the paclitaxel-eluting stent.16.5% v. 6.9%; p=0.03 • There was a trend towards reduced TLR in the siroliumus-eluting stent group. (12.2% vs. 6.4%; p=0.13) (mm) Presented at ACC Scientific Sessions 2005

  5. ISAR-DIABETES Trial Presented at ACC Scientific Sessions 2005

  6. ISAR DIABETES Trial: Summary • Among patients with diabetes and coronary artery disease, treatment with the sirolimus-eluting stent was associated with less angiographic restenosis. • The findings of the ISAR DIABETES trial are consistent with the angiographic findings of the REALITY and SIRTAX trials, which demonstrated improvements in the angiographic parameters of late lumen loss with sirolimus-eluting stents. Presented at ACC Scientific Sessions 2005

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